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Clinical observation of removal of the necrotic corneal tissue combined with conjunctival flap covering surgery under the guidance of the AS-OCT in treatment of fungal keratitis.

Abstract

AIM

To study the clinical observation of removal of the necrotic corneal tissue combined with conjunctival flap covering surgery under the guidance of the AS-OCT in treatment of fungal keratitis.

METHODS

A retrospective study was done to 10 patients (10 eyes) who had accepted removal of the necrotic corneal tissue combined with conjunctival flap covering surgery for fungal keratitis,the diagnosis by corneal scraping and smear examination or confocal microscopy check hyphae.Local and systemic antifungal therapy more than one week for all patients, corneal ulcer enlarge or no shrink.Slit lamp microscope examination the diameter of corneal ulcer about 2mm-4mm.Anterior segment optical coherence tomography (AS-OCT) examine the depth of corneal ulcer between 1/3-1/2,infiltrate corneal stroma about 20um-80um,the diameter of corneal ulcer about 3mm-6mm.Type-B ultrasonic exclusion endophthalmitis. Complete removal lesions until transparent of stroma, make conjunctival flap equal or greater than ulcer 1mm nearby conjunctiva. Continued antifungal therapy. The vision, fungal recurrence, conjunctival flap rollback or desquamate were analysed.

RESULTS

Ten patients had success done this surgery, the corneal ulcer was not enlarge and healing afteroperation.7 cases were bridging conjunctival flap and 3cases were single conjunctival flap. Preoperation vision above 0.1 had 8 cases,7 cases had vision above 0.1 one week after surgery, while 1 cases vision droped from 0.3 to 0.05.There was not recurrent for fungal,2 cases conjunctival flap rollback:1 case was bridging and 1case was single flap, no conjunctival flap desquamate.

CONCLUSION

It is safe and effective to perform removal of the necrotic corneal tissue combined with conjunctival flap covering surgery under the guidance of the AS-OCT in treatment of fungal keratitis which werenot sensitive or aggravate for antifungal drugs.

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  • Authors+Show Affiliations

    ,

    Department of Ophthalmology, Qingdao University Medical College, Qingdao University, Qingdao 266071, Shandong Province, China.

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    Source

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    22553762

    Citation

    Sun, Guang-Hua, et al. "Clinical Observation of Removal of the Necrotic Corneal Tissue Combined With Conjunctival Flap Covering Surgery Under the Guidance of the AS-OCT in Treatment of Fungal Keratitis." International Journal of Ophthalmology, vol. 5, no. 1, 2012, pp. 88-91.
    Sun GH, Li SX, Gao H, et al. Clinical observation of removal of the necrotic corneal tissue combined with conjunctival flap covering surgery under the guidance of the AS-OCT in treatment of fungal keratitis. Int J Ophthalmol. 2012;5(1):88-91.
    Sun, G. H., Li, S. X., Gao, H., Zhang, W. B., Zhang, M. A., & Shi, W. Y. (2012). Clinical observation of removal of the necrotic corneal tissue combined with conjunctival flap covering surgery under the guidance of the AS-OCT in treatment of fungal keratitis. International Journal of Ophthalmology, 5(1), pp. 88-91. doi:10.3980/j.issn.2222-3959.2012.01.18.
    Sun GH, et al. Clinical Observation of Removal of the Necrotic Corneal Tissue Combined With Conjunctival Flap Covering Surgery Under the Guidance of the AS-OCT in Treatment of Fungal Keratitis. Int J Ophthalmol. 2012;5(1):88-91. PubMed PMID: 22553762.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Clinical observation of removal of the necrotic corneal tissue combined with conjunctival flap covering surgery under the guidance of the AS-OCT in treatment of fungal keratitis. AU - Sun,Guang-Hua, AU - Li,Su-Xia, AU - Gao,Hua, AU - Zhang,Wen-Bo, AU - Zhang,Mei-Ai, AU - Shi,Wei-Yun, Y1 - 2012/02/18/ PY - 2011/10/25/received PY - 2012/01/10/accepted PY - 2012/5/4/entrez PY - 2012/5/4/pubmed PY - 2012/5/4/medline KW - AS-OCT KW - conjunctival flap covering surgery KW - fungal keratitis KW - removal of the necrotic corneal tissue SP - 88 EP - 91 JF - International journal of ophthalmology JO - Int J Ophthalmol VL - 5 IS - 1 N2 - AIM: To study the clinical observation of removal of the necrotic corneal tissue combined with conjunctival flap covering surgery under the guidance of the AS-OCT in treatment of fungal keratitis. METHODS: A retrospective study was done to 10 patients (10 eyes) who had accepted removal of the necrotic corneal tissue combined with conjunctival flap covering surgery for fungal keratitis,the diagnosis by corneal scraping and smear examination or confocal microscopy check hyphae.Local and systemic antifungal therapy more than one week for all patients, corneal ulcer enlarge or no shrink.Slit lamp microscope examination the diameter of corneal ulcer about 2mm-4mm.Anterior segment optical coherence tomography (AS-OCT) examine the depth of corneal ulcer between 1/3-1/2,infiltrate corneal stroma about 20um-80um,the diameter of corneal ulcer about 3mm-6mm.Type-B ultrasonic exclusion endophthalmitis. Complete removal lesions until transparent of stroma, make conjunctival flap equal or greater than ulcer 1mm nearby conjunctiva. Continued antifungal therapy. The vision, fungal recurrence, conjunctival flap rollback or desquamate were analysed. RESULTS: Ten patients had success done this surgery, the corneal ulcer was not enlarge and healing afteroperation.7 cases were bridging conjunctival flap and 3cases were single conjunctival flap. Preoperation vision above 0.1 had 8 cases,7 cases had vision above 0.1 one week after surgery, while 1 cases vision droped from 0.3 to 0.05.There was not recurrent for fungal,2 cases conjunctival flap rollback:1 case was bridging and 1case was single flap, no conjunctival flap desquamate. CONCLUSION: It is safe and effective to perform removal of the necrotic corneal tissue combined with conjunctival flap covering surgery under the guidance of the AS-OCT in treatment of fungal keratitis which werenot sensitive or aggravate for antifungal drugs. SN - 2227-4898 UR - https://www.unboundmedicine.com/medline/citation/22553762/Clinical_observation_of_removal_of_the_necrotic_corneal_tissue_combined_with_conjunctival_flap_covering_surgery_under_the_guidance_of_the_AS-OCT_in_treatment_of_fungal_keratitis L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22553762/ DB - PRIME DP - Unbound Medicine ER -